Types of Diabetes Flashcards
what type of cells what insulin
beta cells, islets of langerhans
what type of diabetes has sweet smelling urine
mellitus (greek for honey)
what do all types of diabetic share
an inability to maintain glucose homeostasis (due to either failure of insulin synthesis, release or activity)
what diabetes is RELATIVE not absolute deficiency
type 2
what is diabetes mellitus
group of metabolic diseases characterised by hyperglycemia resulting from defects in insulin secretion, action or both
what is abnormal blood glucose
> 6.1 mmol/L but really more like >5.6 mmol/L
what is the diagnostic criteria for diabetes
*impaired or pre diabetes
HbA1c >48 m/m (42-47m/m*)
fasting glucose >7 mmol/L (6.1-6.9mmol/L*)
2 hour glucose in OGTT >11.1 mmol/L (7.8-11.0 mmol/m)
random glucose >11.1mmol/L
what is the normal ranges for blood glucose
3.3 - 5.8 mmol/L
what is type 1 diabetes
autoimmune disease resulting in beta cell destruction, usually leading to absolute insulin deficiency
what is type 2 diabetes
progressive loss of beta-cell insulin secretion (causing hyperinsulinaemia) frequently on the background of insulin resistance
what is gestation diabetes mellitus
Any degree of glucose intolerance arising or diagnosed during pregnancy
what is MODY
maturity onset diabetes of the young
what antibodies re usually found in T1DM
anti-GAD/ anti- islet cell antibodies
what might be seen histologically in T1DM
insulitis- lymphocytic infiltrate
what is the typical presentation of type 1 diabetes
pre school and peri puberty small peak in late 30's usually lean acute onset severe symptoms severe weight loss ketonuria +/- metabolic acidosis no evidence of microvascular disease at diagnosis immediate and permanent requirement for insulin
what are the risk factors for type 2 diabetes
obesity (central) familial race CVD gestational diabetes hypertension high cholesterol/ triglyceride polycystic ovary syndrome inactivity medications (antipyschotics)
when should all patients get tested for diabetes
45 years
how do you test for type 2 diabetes
fasting glucose, 2-hr plasma glucose during 75 g oral glucose tolerance test, A1C
what are the symptoms of diabetes mellitus
thirst polyuria thrush weakness fatigue blurred vision infections weight loss T2DM- complications- neuropathy, retinopathy
what discriminatory tests can be used
autoimmune markers- anti-GAD, anti insulin, anti tyrosin phosphatases
ketones
C peptide
in type 1 there is a strong HLA association
what is LADA and how do you distinguish it from T1DM
latent autoimmune diabetes of adults. type of diabetes mellitus with later onset than type 1
ketosis= type 1
do people with idiopathic T1DM have B cell autoimmunity
no
is idiopathic T1DM HLA associated
no, but strongly inherited
what is type three diabetes
gestational
what is type 4 diabetes
can arise from: drug induced abnormalities of insulin and its receptor genetic diseases pancreatic disease endocrine disease
what pancreatic diseases can cause type 4 diabetes
chronic/ recurring pancreatitis (gall stones/ alcohol)
haemochromatosis
cystic fibrosis
what endocrine diseases can cause type 4 diabetes
cushings syndrome
acromegaly
phaechromocytoma
glucagonoma
what drugs can cause type 4 diabetes
glucocorticoids
diuretics
b blockers
what genetic diseases can cause type 4 diabetes
cystic fibrosis
myotonic dystrophy
turners syndrome
what should you look out for which would suggest monogenic diabetes
Strong Family History Associated Features (renal cysts etc) Young Onset GAD-negative C-peptide positive
what does HbA1c show
measure of glucose control over the past 2-3 months
what are the complications of diabetes
macro-vascular: heart disease, storke, CVD, atheroma
micro-Vascular: retinopathy (blindness), nephropathy (kidney failure), neuropathy- foot ulcers (charcots foot)
psychiatry/ psychology
which test is diagnostic of diabetes
fasting blood glucose
